Saturday, August 8, 2009

(Please note, the following post is NOT meant to convey any viewpoint about abortion. Any comments trying to fight-out or inflame pro-life vs. pro-choice opinions will not be published).

I use the word "abort" in my dictations: "Her migraines are aborted by Imitrex" or "He was seen in ER, where the seizure was aborted by Ativan" or "The MRI was aborted due to his claustrophobia".

At least twice a year, most recently yesterday, I get an angry letter or phone call from some patient who is reading my notes on them and becomes incensed over this. They see the word and automatically assume it means they HAD an abortion (No, sir, that is biologically impossible") or that my use of the word is expressing a political viewpoint ("I'm devoutly pro-life! How dare you use that word in a note about me!").

Usually I just explain to them what it means, and send them to a dictionary. It's amazing how many people are stunned to find out it has some other meaning then THAT ONE, and are fine once they realize this.

In spite of this, in the last 10 years I've had 3 patients change neurologists over this issue. Whatever.

Part of being a doctor is respecting your cultural, religious, and political beliefs. That's why I never discuss mine. Words in my notes are just that. Words.

31 comments:

Education. That thing where you go to school and read and learn words, but they call it "vocabulary." Also they teach how to put words together in a good way, like sentences. Sometimes ppl evn lrn how 2 spell.

Kinda crazy. People need to get acquainted with this book that has the word dictionary written on it. I am not a native speaker (of English) but I still know that '(to) abort' is not just used for embryos and fetuses. Some people really get upset for no reason.

in therapy notes, we frequently write that the informant "denied a history of ______." this indicates that we asked and they said no. as a result, i have had more than one person infuriated with me because they think my reports are filled with implications that they are lying.

The change in the word abort to the more common meaning is part of the "euphamism treadmil." Here's a quote from an article I just read:

"Abortion originally meant premature birth, and came to mean birth before viability. The term "abort" was extended to mean any kind of premature ending, such as aborting the launch of a rocket. Euphemisms have developed around the original meaning. Abortion, by itself, came to mean induced abortion or elective abortion exclusively. Hence the parallel term spontaneous abortion, an "act of nature", was dropped in favor of the more neutral-sounding miscarriage."

At my pharmacy, the prescription labels have all the pharmacists initials that dealt with the script printed on it. At least once a month, someone accuses us of putting "codes" on their bottle that we use to label them as problem patients. I guess they haven't figured out we really put microchips in the capsules so we can track them with GPS.

I have to say, despite being an English professor who knows the varied meanings and contexts for the word, it didn't feel good when I had my second miscarriage and saw "habitual aborter" written on my chart. My mother-in-law still remembers having a miscarriage and a nurse walking in her hospital room saying, "Are you the one who had the abortion?" . . . and she didn't know there was any other meaning. I would never complain, though; I know it's only terminology When it comes to migraines, I really don't see why anyone would respond in that way.

I had a similar experience during A & P II class last year. The Professor was explaining a disease that could cause spontaneous abortion and used that exact term to describe it. One of the nursing students, raised her hand and when called upon, asked him if he would use the term miscarriage instead. He then proceeded to explain, not so kindly, that the term abortion IS the appropriate term and miscarriage is not. He also told her to grow a thicker skin if she wanted to be a successful nurse because she actually wanted to argue the point with him that, "no, abortion is not a medical term." I just chuckled and enjoyed the show.

It's unbelievable. One of the causes of my dearly loved father in law was "exacerbation of prostate cancer". The ruddy registar's office (when births deaths and marriages are reported in the UK)did not know the meaning of the word "exacerbate" and refused to believe me when I said it meant "worsening". Nor did they have a dictionary in the office!. We waited three hours in a blazing hot office with two toddlers before they found a senior registrar who said that my definition was correct. Arrrghhhh!!!!

I think there are people around who think solely in emotions, and use words that to them convey specific emotions. The trouble comes when speaking with other people who understand critical thinking, and that words are just words.

Yes I've had several people who come in for an ultrasound with an order from their doctor with the diagnosis "spontaneous abortion" and have the patient clarify that they aren't having an abortion, but a miscarriage. That's when I like the doctors that will just write "SAB".

In the early 80s I had a co-worker - devoutly religious - who was offended by the word "abortion" - didn't matter that we were using it in an IT environment - ie - the program aborted. We explained. She was still offended. We ignored her. She got over it.

Welcome to my whining!

This blog is entirely for entertainment purposes. All posts about patients may be fictional, or be my experience, or were submitted by a reader, or any combination of the above. Factual statements may or may not be accurate.

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